| NPI | 1699417956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY K SULLIVAN Manager/Nurse Practitioner 417-848-7976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2022-04-08 |